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Britons will spend more money on cosmetic surgery than cups of tea by the end of next year, according to a new report. We look at the most popular procedures and get advice on choosing a surgeon. Words by Gabrielle Fagan

COSMETIC surgery was once the preserve of the rich and famous but now it's becoming so acceptable that Britons are expected to spend more on nips and tucks next year than on cups of tea.

Our quest for physical perfection could lead us to spend £659 million in 2007 on a variety of procedures from face lifts to boob jobs, according to analysts Mintel.

Procedures on the face and neck are the most popular choices but breast enlargements are close behind - they're up 150 per cent compared to 2003 - with around 26,000 operations carried out last year.

Louise Braham, development director of the Harley Medical Group, believes TV shows featuring cosmetic surgery and its popularity among celebrities such as Jordan and Sharon Osbourne have helped fuel the trend.

"Publicity has taken the taboo and scariness away. People now feel more confident about exploring what's available and have more disposable income to fund it.

"People want to turn the clock back and they're happy to opt for cheaper fixes such as quick, easy non-surgical procedures like Botox which don't involve recovery time."

Those opting for cosmetic help generally fall into two categories, she says: people who want what they regard as a 'life-changing' operation to alter a feature which they believe is affecting their confidence and self-esteem, and those who want to refresh their looks for vanity reasons.

This year there will be some 690,000 cosmetic surgery procedures carried out in Britain, up 40 per cent on last year. But increasing popularity doesn't mean it's risk-free.

Consultant plastic surgeon Dr Judy Evans, a former council member of the British Association of Aesthetic Plastic Surgeons (BAAPS), says some people ignore the fact that any surgery carries risks and have unrealistically high expectations of what can be done.

"Ideally people should regard surgery as putting right a feature which is maybe making them extremely self-conscious or seriously affecting their lifestyle. It should not be a fashion statement because going up three cup sizes will not necessarily change your life."

And people should do their homework before choosing a surgeon or centre, she stresses.

"Don't rush into anything - even for a minor operation there can be serious risks involved and a hasty decision could result in irreparable damage."

She recommends waiting until you find a surgeon you feel comfortable with so you can talk honestly about what you hope to achieve and why.

"A reputable surgeon would want to see you twice before agreeing to surgery. This gives you time to consider the operation and whether you're doing it for the right reasons."

Breast enlargements

These change the shape of and/or enlarge breasts, or repair the breasts after surgery or trauma. For breast implants, the surgeon makes a small cut underneath the armpit, beneath the nipple, underneath the breast or in the abdomen before inserting the implant. Treatment normally takes around one hour, and the procedure usually involves a general anaesthetic. You will need a week off to rest.

Result: Breasts should be larger, and asymmetric breasts can be evened up. There will be some scarring.

Risks: Infection, blood loss or rupture or leakage of the implant. Some implants need to be replaced after approximately 15 years.

Botox

This is a non-surgical procedure which temporarily reduces the appearance of wrinkles on the forehead, between the brows and around the eyes. It can sometimes be used on the lower part of the face and neck, often in combination with dermal fillers. Injections of botulinum toxin block the nerve signal from your brain to your muscles causing them to move into a smile or frown. The untreated facial muscles work normally and facial expressions are not affected.

Result: The area treated should appear smoother and less wrinkled. Results may take two to three weeks to appear and the effects last from around three to four months.

Risks: Occasionally patients who have injections in the forehead experience drooping of the eyelids or eyebrows. Rarely double vision or blurred vision can occur which requires medical attention.

Facelift

There are many different kinds of facelifts, but they all work to reduce flabby jowls and smooth the jawline. Generally the surgeon frees the skin by making an incision in the hairline from the temple, round and behind the ear and into the hairline. The skin is then pulled up and backwards and excess fat removed. Those using an endoscopic technique can be performed without leaving visible external scars. It can take up to six hours and usually takes place under general anaesthetic. It requires an overnight stay and two weeks off work.

Result: Most people find they look about ten years younger afterwards. The scars of the operation will be permanent, although they are usually hidden by your hair.

Risks: Some people can suffer hair loss, scarring and rough skin. Risks also include nerve damage which can cause numbness or temporary paralysis of part or all of the movement of the facial muscles.

Tummy tuck

Partial or full tummy tucks alter the shape of the abdomen by removing fat and excess skin. In a partial tuck, the surgeon makes a large incision across the lower abdomen, then separates the skin from the abdominal wall, removes excess fat and cuts away excess skin. The remaining skin is then pulled down and stitched together at the line of the first incision. The operation usually takes place under general anaesthetic and can take up to three hours. You will need to stay overnight in hospital and have two weeks off work to rest.

Result: Your stomach should appear flatter and abdominal muscles should feel and look firmer as they may have been repaired.

Risks: There are general risks associated with surgery. Scars usually fade after a year, but will be permanent. Puckering on the outside edge of the scar may remain.

For more information on cosmetic surgery and non-surgical treatments, visit www.dh.gov.uk/cosmeticsurgery. For more information about the Harley Medical Group, call 0800 085 9085 or visit www.harleymedical.co.uk. The British Association of Aesthetic Plastic Surgeons (BAAPS) has an advice line and search facility for accredited surgeons: 020 7405 2234/www.baaps.org.uk.

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